Recently, the word “care” has become one of the most common terms used to describe a feeling we all want. But what is care? As a noun, it is defined as: the provision of what is necessary for the health, welfare, maintenance and protection of someone or something. As a verb, its definition is: feel concern or interest; attach importance to something. Given the times, it’s no wonder we all want to feel care. Care is a fundamental human need like food and water. We are born needing care to survive, and we depend on others to provide that care. As we develop, we learn to recognize and appreciate care. We look up to and emulate what we perceive as care in order to care for others. This cycle sustains life and allows us to flourish. Care is naturally human-based. Given the origins of care, we are more likely to care for people like ourselves. To fully understand the implications of this, we must be honest about who we are and who we view as different. When people began to form institutions and organizations, they were often associated with care. It certainly makes them more appealing and less threatening. They however only reflect the level of care of the individuals who comprise them. Charlottesville is a town of many organizations and institutions. Historically, the two largest institutions have been slavery and the University of Virginia. Lately, the intertwined relationship between the two is getting some overdue attention. Present day ramifications are still coming to light. We must take a closer look at the role care has played to better understand what is happening. Local Black peoples sometimes refer to UVA as “The Plantation” for good reason. It was designed by Thomas Jefferson and influenced by his plantation, Monticello. Many of the architectural features at both locations serve the same purpose: hiding the people who provided care from view. One can notice that focusing one’s attention away from the enslaved people was a key element of his designs. Over the years, I have watched UVA attempt to pivot its relationship with the local Black community. Unfortunately, these efforts have had limited returns. One reason I believe this happened is that UVA has tried to rebrand itself as a caring institution without acknowledging this is fundamentally not true. From its inception, the purpose of UVA was to prepare the next generation of privileged white males. The enslaved, and later the entrapped, Black people of the community were used to provide care. Expanding the ranks of the privileged to include women and other races did little to change the formula. UVA’s recent outreach efforts are based on the notion that it cares about the community. The truth is: Charlottesville hosts the university. Without the care and labor of Charlottesville, UVA would not be what it is today. Sadly, the opposite is also true. The plight many Black people find themselves in is due to a lack of concern by UVA.

The Emergency Department at the University of Virginia Medical Center. Credit: Credit: Elliott Robinson/Charlottesville Tomorrow Credit: Credit: Elliott Robinson/Charlottesville Tomorrow

UVA Health is one example of this relationship. The university began teaching medicine well after its inception by Jefferson, but it carried on his tradition.  From the beginning, it focused on the treatment of white people. Like all segments of the school, in the hospital, Black people were relegated to serving its needs. When care was provided for them, it was substandard and given in areas that were out of sight, like the basement. The school embraced teachings such as eugenics to justify its practices. Recently, those truths have come to light, and there has been a concerted effort to distance itself from the past. Name changes have occurred, and departments have been formed to address equity. But changing the ethos of a system that is so deeply rooted in inequity will require more. A slick ad campaign that portrays it as a caring institution only rubs salt into the wounds it’s caused. I am very familiar with this feeling. UVA Health has impacted my life from birth. My father was a respiratory therapist at UVA when I was born in 1958. He observed the substandard conditions Black people encountered firsthand at the hospital. My mother had worked there also and was concerned about the maternity care she would receive. She opted to deliver me at home under the care of a local Black physician assisted by a neighbor with no training. To their surprise, I was a twin, and my sister became tangled in her umbilical cord. She died. Would the outcome have been different if she had been in the hospital? I will never know, but I do know why she chose not to be there. At the time my father worked at UVA hospital, respiratory therapy was the only department headed by a Black person, and all his coworkers were Black. He left because he was paid more to work at the post office, where most of his coworkers in the position he held were white. Today, the opposite is true, and so is the pay. Verbiage and images can carry a powerful message. A quick look at the UVA health care website shows a Black couple paying their bill and a Black man pushing a wheelchair. This may not bother most people, but to those who have experienced the aggressive billing practices and minimal job prospects, this is traumatic and emblematic of a system that has failed them. This is a truth that we as a community can no longer afford to ignore despite the fact it may tarnish the image some may have of Jefferson’s prized institution.


Philip Cobbs was born and raised in Albemarle County, and his family lineage extends back at least four generations in the county. A graduate of Piedmont Virginia Community College, he is a craftsman, author, educator, businessman and farmer.